Ethics (episode)
After Worf is paralyzed by a freak accident, his only hope may be a visiting doctor with questionable medical ethics. Summary Teaser Lieutenant Worf and Lieutenant Commander Geordi La Forge are in cargo bay three investigating strange readings. Their tricorders are unable to detect the exact problem. Worf is preoccupied with his loss to Deanna Troi in a poker game, and no one realizes that a large, heavy container sitting on a high shelf is leaking. Another similar container is sitting on top of it. Eventually, enough of the material leaks out that the lower container begins to buckle under the weight of the upper container. The two containers fall, and the upper container hits Worf in his back. La Forge summons emergency medical assistance. Worf wakes up in sickbay to find out from Dr. Crusher that his spinal cord has been crushed, resulting in paralysis. Act One :"Captain's log, stardate 45587.3. Lieutenant Worf has been removed from active duty following a severe injury. Although a neuro-specialist has arrived, Doctor Crusher believes his paralysis may be permanent." The arrives with Dr. Toby Russell, a neurological specialist, who Dr. Crusher has called in. She is brought to the by the . The two doctors find themselves in uncharted territory: in Klingon medicine those who are paralyzed are allowed to die. Klingons with these injuries would often commit Hegh'bat, the Klingon ritual suicide. Dr. Russell is amazed by Klingon anatomy, which has twenty-three ribs, two livers, and an eight-chambered heart. For Klingons, this is called the brak'lul, meaning every vital function has a backup system, though Russell notes that this also means there are many more ways it can go wrong. Commander Riker goes to visit his friend in sickbay. Worf asks him for a favor. When Riker tells him to name it, Worf asks Riker to help him commit hegh'bat. Riker is shocked and repulsed by what Worf is asking for – basically to hand him a knife and leave him to stab himself in the heart. Act Two Dr. Russell proposes a new surgical procedure for Worf to Dr. Crusher. Dr. Russell believes that she can use what she calls a genetronic replicator to create an entirely new spinal column for Worf. But it would be the first time she had done this on a living being, having only conducted tests of this new procedure on holographic patients and claims the success rate is now up to thirty-seven percent. Dr. Crusher refuses to consider it; not only is the success rate too low but they will need to remove Worf's spinal column and, given their limited knowledge of Klingon biology, if something goes wrong they won't be able to reattach it and he'll die. Dr. Russell agrees to drop the idea. Meanwhile, the Enterprise diverts to render aid to the , after the latter struck a Cardassian gravitic mine while transporting over five hundred colonists. Dr. Crusher sets up triage units in the shuttlebays, and accepts Russell's offer for assistance. Commander Riker discusses Worf's request with Captain Picard telling him that, although he always tries to understand and respect the traditions of other races and cultures, the idea of assisting Worf in suicide disgusts him especially as Worf could still live a full life despite his injury. Picard however is more understanding of Worf's request, explaining to Riker that while a Human could adapt, when a Klingon is unable to stand and fight they consider their life to be over. Picard can't make Riker's decision for him and understands how frustrated he feels over the situation, but encourages him to make it based on his friendship with Worf. Klingons choose their friends very carefully, and if Worf didn't know if he could count on Riker he wouldn't have asked. Alexander is upset over his father's accident, and even more upset that Worf will not allow Alexander to see him in his condition. Counselor Troi tries to reason with Worf over this. At first, Russell and Crusher have Worf try using devices to transmit impulses to the appropriate muscles. But when it is revealed that Worf would not have full mobility, he refuses to use the devices. Against Crusher's wishes, Russell proposes the genetronic procedure to Worf. Act Three Doctor Crusher takes Russell aside and argues with her that they had already talked about and ruled out the procedure, and, furthermore, giving him that option is taking advantage of his desperation. Russell is picking up on Worf's frustration with his condition and is convinced he would want it. Crusher says she checked on her proposals at Starfleet Medical, seeing they were denied three times for humanoid patients. They get interrupted when Picard calls to inform her that the Denver survivors will soon be beaming aboard. Troi brings Alexander to see Worf, who has propped himself up to a standing position next to his bed, and is seen standing with the neurological devices strapped to his thighs. He begins to discuss the situation with Alexander, telling him there will be difficult times ahead. He loses his balance and falls. Feeling humiliated, he gruffly orders Alexander to leave. After meeting the other ship, the Enterprise medical staff begin treating casualties. Dr. Crusher discovers that a patient under Dr. Russell's care had died after Russell tried an untested, experimental treatment, borathium, despite a chance standard treatments would have saved his life. Outraged by Russell's reckless choice of a radical approach over conventional treatment, Crusher relieves Russell of duty, and tells Russell that she will not be permitted to practice medicine any longer while on board the Enterprise. Act Four Picard meets with Dr. Crusher in her office after he learns that she has relieved Russell of duty. She had found that Starfleet Medical had refused permission to allow Russell to use living subjects for her procedure. Crusher says that Worf is basically healthy for the time being, but that if he went into surgery he could die. Picard tells her that she should consider allowing Russell to perform the operation. Even though Crusher knows Worf could have a full life even with this paralysis, Picard explains that Worf's society says that his life was over the moment he was struck by the container. To ask him to accept living without full mobility despite a lifetime of differing values and beliefs is realistically just too difficult. He could possibly be convinced to forgo suicide and take a chance with Russell's procedure, as risk is something Klingons know all about. The only way to save Worf's life is to do this because otherwise, Worf will eventually kill himself. Riker has studied the hegh'bat in detail and bluntly finds it despicable in the way it tries to "cloak suicide in some glorious notion of honor". Worf protests to Riker that each of them must die in their own time. Riker forcefully reminds him of their fellow crewmates who perished while serving with them on the Enterprise - Sandoval, Fang-lee, Marla Aster and Tasha Yar, to name a few, who all fought for life until their last moments. Riker then tells him that even though he strongly disagrees with the Klingon custom, he would most likely assist Worf except for one detail. He finds in his research that Worf's son Alexander – his only immediate family member – would need to be the one to assist in the ritual. Worf protests that his son is a child, but Riker counters that "the son of a Klingon is a man the day he can first hold a blade." It is not Riker's place to help Worf commit suicide, and he's figured out that it would be too hard for Worf to ask his son to watch him kill himself. In light of this, Worf summons Alexander to sickbay and informs him that he has chosen not to kill himself, but instead to try the surgical procedure suggested by Dr. Russell. Act Five :"Chief medical officer's log, supplemental. After further consultation with Starfleet Medical, and a great deal of soul searching, I have reluctantly granted Lieutenant Worf's request to undergo the genetronic procedure." Worf goes into surgery. Before going, he asks Counselor Troi if she would raise Alexander if he does not survive the operation, and she accepts. Russell and Crusher remove the old spinal cord. They use the gentronic scanner to try to scan Worf's spinal cord, but the main scanner has trouble reading the cord. Russell scans the remainder of the cord herself. Once that's done, they begin generating a new spinal cord. Everything seems to go right until the end of the operation, when suddenly Worf crashes. Nurse Ogawa can read no vital signs from Worf and he has died on the operating table. Crusher goes to sickbay to tell Alexander that Worf has died. Alexander demands to see his father. While they are viewing the body, Worf's synaptic functions suddenly reactivate; his brain also apparently had a backup system. This allowed him to survive the operation. Soon his body begins functioning again. While thrilled that Worf will recover, Crusher is disturbed by Russell's attitude of "the ends justify the means." Crusher tells Russell that she gambled with Worf's life and won, but real research is a slow and painstaking process and should never be put ahead of patients' lives. After the operation, Worf begins the process of physical therapy. The process is slow as it takes time for Worf's body to adjust to the new spinal cord; Worf stumbles while he re-learns to walk. Watching his father stumbling, Alexander starts to move to him, but Deanna reminds him of the Klingon stoicism about which she's spoken to him. Surprisingly, Worf asks for Alexander's help, and tells him that they will struggle together. With that, Worf begins his long journey towards recovery. Log entries * [[Captain's log, USS Enterprise (NCC-1701-D), 2368#Worf's broken back|Captain's log, USS Enterprise (NCC-1701-D), 2368]] * [[Medical officer's log, USS Enterprise (NCC-1701-D)#2368|Medical officer's log, USS Enterprise (NCC-1701-D)]] Memorable quotes "No question about it: she was bluffing, Worf." "Bluffing is not one of Counselor Troi's strong suits... It would have been unwise to call. Yes, my hand was not strong enough!" "You had Jacks and eights; she bluffed you with a pair of sixes!" "How did ''you know what I had?" "''Let's just say I had a special 'insight' into the cards..." (points to his VISOR) "Maybe next time you should bring a deck that's not transparent to infrared light." : - La Forge and Worf, discussing a recent officers' poker game "I've done dozens of holo-simulations. The success rate is up to 37 percent." "Even a holographic patient would balk at those odds." : - Dr. Russell and Dr. Crusher, discussing Dr. Russell's experimental surgery "He's been injured and he's embarrassed. And to have anyone see him now would make him feel worse. Even if it were you." "This is part of that Klingon stuff, isn't it? My mother always said Klingons had a lot of dumb ideas about honor." "That Klingon stuff is very important to your father." : - Troi and Alexander, discussing why Worf wouldn't see his son in his injured state "Do you remember Sandoval? Hit with a disruptor blast two years ago. She lived for about a week. Fang-lee, Marla Aster, ''Tasha Yar! How many men and women, how many friends have we watched die? I've lost count. Every one of them, every single one, fought for life until the very end." : - '''Riker', arguing with Worf about his decision to commit ritual suicide "Will you or will you not help me with the ''hegh'Bat?" "''You are my friend. And in spite of everything I've said, if it were my place, I would probably help you. But I've been studying Klingon ritual and Klingon law, and I've discovered that it's not my place to fill that role. According to tradition, that honor falls to a family member. Preferably the oldest son." "That is impossible! He is a child!" "The son of a Klingon is a man the day he can first hold a blade.' True?" "''Alexander is not fully Klingon! He is part Human!" "That's an excuse. What you really mean is that it would be too hard to look at your son and tell him to bring you the knife, watch you stab it into your heart, then pull the knife out of your chest and wipe your blood on his sleeve." : - '''Worf and Riker "There is much to discuss. There will be difficult times ahead. You must be strong." : - Worf, to his son Alexander after his accident and subsequent paralysis "You want ''me to raise Alexander?" "''I have come to have a great respect for you, Deanna. You have been most helpful in guiding me since Alexander's arrival. I can't imagine anyone who would be a better parent to my son." : - Troi and Worf "Ok, 25 cc cordrazine." "That'll kill him." "Looks like we've done a pretty good job of that already, Doctor." : - Dr. Crusher and Dr. Russell, attempting to revive Worf "I am delighted that Worf is going to recover. You gambled. He won. Not all of your patients are so lucky. You scare me, Doctor. You risk your patients' lives, and justify it in the name of research. ''Genuine research takes time. Sometimes a lifetime of painstaking, detailed work in order to get any results. Not for you. You take shortcuts, right through living tissue. You put your research ahead of your patients' lives. And as far as I'm concerned, that's a violation of our most sacred trust. I'm sure your work will be hailed as a stunning breakthrough. Enjoy your laurels, Doctor. I'm not sure I could." : - '''Dr. Crusher', confronting Dr. Russell "We will work together." "Yes, sir." : - Worf and Alexander Rozhenko, as Worf begins to learn how to walk again (last lines) Background information Production history * Final draft script: * Filmed: 11 December 1991 – 20 December 1991 * Second unit and insert footage filmed: * More second unit and insert footage filmed: 14 February 1992 * More second unit and insert footage filmed: 21 February 1992 * Premiere airdate: * First UK airdate: Production * "Ethics" was filmed between Wednesday and Friday on Paramount Stage 8, 9, and 16. It was the last episode to be filmed in . Between and , the production went into company holiday. Second unit and insert shots were filmed on Tuesday on Paramount Stage 9 and 16, on Friday on Paramount Stage 8 and 9, as well as on Friday on Paramount Stage 9. * During most of the surgery, Worf was played by Al Foster, the photo double for Michael Dorn. * The containers which fell onto Dorn's stunt double Rusty McClennon were made of styrofoam. (Call sheet) * The call sheet for Wednesday reminded the crew to bring in baby photos for the contest on the following Friday. Continuity * Dr. Russell makes reference to a paper Dr. Crusher has written regarding cybernetic regeneration, which Crusher had previously mentioned developing a workable approach on in . * While describing his disdain for the hegh'bat ritual, Riker makes mention of the deaths of Marla Aster ( ) and Natasha Yar ( ). * In an alternate reality shown in the 7th season episode , Worf and Deanna Troi fall in love after his operation, and the couple soon marry. * Unlike , it was not clarified if this form of ritual Klingon assisted suicide would allow a Klingon soul to enter Sto-vo-kor (though it can perhaps be inferred as such, from the fact that it is an accepted ritual of the Klingon culture). * It is worth noting that, while Commander Riker was encouraged by Captain Picard to carry out the ritual of hegh'bat, Worf himself was arrested by Odo and berated by Sisko for attempting a similar ritual on his brother Kurn in . * When asking Riker to help him by performing the hegh'bat ceremony, Worf says "help me end my life as I have lived it". Seven years later, Kor repeats that phrase to Worf, word for word, when asking him to help him undertake his final mission in . * During this episode, it is revealed that Klingons have visible ridges on their spines and feet as well as their foreheads. Reception * A mission report for this episode, by John Sayers, was published in . Apocrypha * In the novel A Time for War, A Time for Peace, the Enterprise-E is being inspected by a Starfleet team and Dr. Russell is inspecting the medical department. In another argument between Russell and Dr. Crusher, Crusher remarks again about genetronics. Russell is amazed that Crusher is still upset about her procedure, which was successful; Crusher remarks that it only barely worked and that was because of the unique nature of Klingon physiology. Crusher also notes, much to Russell's irritation, that in the decade or so since Worf's surgery, after the initial wave of articles about it, nothing has ever been heard again regarding genetronics. Video and DVD releases * Original UK VHS release (two-episode tapes, CIC Video): Volume 58, * UK re-release (three-episode tapes, Paramount Home Entertainment): Volume 5.6, * As part of the TNG Season 5 DVD collection Links and references Starring * Patrick Stewart as Jean-Luc Picard * Jonathan Frakes as Cmdr. William Riker Also starring * LeVar Burton as Lt. Cmdr. Geordi La Forge * Michael Dorn as Lt. Worf * Gates McFadden as Dr. Beverly Crusher * Marina Sirtis as Counselor Deanna Troi * Brent Spiner as Lt. Commander Data Guest stars * Caroline Kava as Toby Russell * Brian Bonsall as Alexander Rozhenko * Patti Yasutake as Alyssa Ogawa Uncredited co-stars * David Keith Anderson as Armstrong * Rachen Assapiomonwait as * Lena Banks as operations division ensign * Bowman as science division officer * Michael Braveheart as Martinez * Carl David Burks as Russell * Denise Deuschle as science division officer * Grace Harrell as operations division ensign * as science division officer * Landi as civilian * Mark Lentry as science division lieutenant * Tim McCormack as ''Denver'' dead body * Michael Moorehead as science division ensign * Joyce Robinson as ''Denver'' dead body * Sissy Sessions as operations division ensign * John Tampoya as command division ensign * Christina Wegler Miles as ''Denver'' dead body * Unknown performers as ** Female medical aide ** [[Denver colonists 001|Fifteen wounded Denver colonists]] ** [[Denver crewmembers 001|Four wounded Denver crewmembers]] Stunt double * Rusty McClennon as stunt double for Michael Dorn Stand-ins and photo doubles * Mikki Acedo – stand-in for Patti Yasutake * David Keith Anderson – stand-in & photo double for LeVar Burton * Al Foster – photo double for Michael Dorn * Johnny Hayden – stand-in for Brian Bonsall * Tim McCormack – stand-in for Brent Spiner * Melba – stand-in for Marina Sirtis * Lorine Mendell – stand-in for Gates McFadden * Richard Sarstedt – stand-in for Jonathan Frakes * Sissy Sessions – photo double for Patti Yasutake * – stand-in for Caroline Kava * Dennis Tracy – stand-in for Patrick Stewart * Dru Wagner – photo double for Caroline Kava * James Washington – stand-in for Michael Dorn References active duty; Adelman Neurological Institute; alkysine; anatomy; ; Beloti sector; bio-active interface; biobed; blood; BP; Borathium; brak'lul; bureaucracy; Cardassian war; cargo bay; case history; cauterization; cc; centimeter; cerebral cortex; cervical vertebra; ; chlorinide; chloromydride; civilian; colonist; cordrazine; cortical spinal tract; cortical stimulator; CPK enzymatic therapy; crew; cybernetics; cybernetic regeneration; ; detronal scanner; disability; DNA; DNA sequencer; drechtal beam; Duras, son of Ja'rod; dynoscanner; Earth; empirical knowledge; exoscalpel; Fang-lee; genetronic replicator; gravitic mine; heart; heart rate; Hegh'bat; inaprovaline; incurable disease; infrared; isocortex; K'Ehleyr; Klingon; Klingon Civil War; Klingon database; Klingon Empire; Klingon law; Klingon Medical Division; Klingon ritual; knife; laser scalpel; leporazine; ; liver; medical emergency; medical ethics; Mericor system; morathial series; motor assist band; multiplication; neural metaphasic shock; neural transducer; neurogenetics; Neuro-specialist; Number one; oxygen; parallel bars; patient; pia mater; poker; polyadrenaline; ; rejection; restraining field; rib; Romulan; ; ; ribosome infusion; rite of death; rybotherapy; Sandoval; Sector 37628; shock; shuttlebay; sickbay; sleeve; spinal column; spinal cord; spinal tract; spine root; Starfleet; Starfleet Medical; steri-field; straw; stress simulation routine; suicide; supposition; surgical support frame; synaptic response; terminal illness; thalamic booster series; theory; torso; training device; triage; tricorder; ''VeK'tal'' response; vertebra; VISOR; warp coil; week; Unreferenced production material Kelnaria region; Mylaira system; Starbase 27 External links * * * * |next= }} de:Die Operation es:Ethics fr:Ethics (épisode) ja:神経医療エキスパート ドクター・ラッセル（エピソード） nl:Ethics pl:Ethics (odcinek) Category:TNG episodes